EHR Incentive Payment Program Training FAQ and Resources. December 8, 2011

Transcription

1 EHR Incentive Payment Program Training FAQ and Resources December 8, 2011

2 Topics CMS Registration Prequalification for Groups Prequalification for Individual Providers Medi-Cal Eligibility Requirements AIU Verification Group Registration Other

3 CMS Registration Questions How do I register with CMS? Do all providers need a NPPES log-in to complete Federal registration? Where can I find out if I registered many months ago for federal program and don't have my registration number? How to escalate NPPES requests for usernames and passwords? Is there group federal registration?

4 Resources: CMS Registration Questions CMS Registration site - State Level Registry - Guide to CMS registration - ginners_guide.pdf NPPES

5 CMS Registration Questions Contacts: NPPES: help with NPI numbers CMS Help desk User ID/Password help Jon Langmead ,

6 Medi-Cal: Prequalification for Groups What is a group and what are the benefits of establishing eligibility as a group? What types of Medical Groups and Clinics are prequalified? We were on the prequal list but didn t get an or did not respond. What do we do? Is prequal always by site, or can a whole Organization be prequalified? If the clinic qualifies on an entire year of OSHPD data, do the providers have to have worked for the clinic for the whole year?

7 Resources: Prequalification for Groups Understanding Groups PDF document Quick Start Guide PDF document List of Prequalified Clinics PDF document Website hit.aspx Prequal notification issues

8 Contacts: Prequalification for Groups Michael Marchant at ACS, California Department of Health Care Services, Office of Health Information Technology, , Medi- ACS Help Desk Number or OSHPD questions, ,

9 Prequalification for Individual Providers (1 of 2) What does the prequalification process look like for individual EPs? Specifically, who, when and how will they be notified that they are prequalified for the Medi-Cal Incentive Program? What documentation for the 30% Medi-Cal visit threshold will be required for non-prequalified EP s?

10 Prequalification for Individual Providers (2 of 2) If a Provider is listed through a Group registration, does that provider need to register individually in the SLR? How does the Medi-Cal process works if a Provider has been identified as Hospital-based by CMS? Providers who will be paid by Medi-Cal must be in the Provider Master File. What happens if a provider tries to register in the SLR and is not in the PMF? How can a provider be included in the PMF?

11 Prequalification for Individual Providers Resources: Provider FAQs PDF document Contacts: Michael Marchant at ACS, California Department of Health Care Services, Office of Health Information Technology, , Medi-

12 Medi-Cal Eligibility Requirements Which segments of the Medi-Cal Payer mix count toward the volume to qualify? What about Medi-Medi s? How are the 90 days for eligibility selected? What year do the 90 days occur in: 2010? 2011?

13 Resources: Medi-Cal Eligibility Requirements Eligibility criteria Medi-Cal FAQ PDF document Contacts: California Department of Health Care Services, Office of Health Information Technology, , Medi-

14 AIU Verification For Adoption, is having a signed contract good enough or does the EHR system actually have to be installed? Does the contract have to be in place by 12/31/11 or 2/29/12? Do we have to be using the certified version? There is a both a Group A/I/U document and an EP A/I/U document on the SLR. Do groups have to submit both the group document and a signed A/I/U document for each individual EP? Where in the Group registration process does the verification of AIU (letter of documentation and/or contract) get attached?

15 Resources: AIU Verification Group AIU Documentation Forms PDF document Contacts: California Department of Health Care Services, Office of Health Information Technology, , Medi-

16 Group Registration (1 of 2) Do my individual providers need be registered at the NLR prior to registering the "group" on the SLR? If a provider within a group does not want to use the group s encounters to establish eligibility, can the remaining providers still use the group s encounters to establish eligibility? Is there a relationship between establishing eligibility as a group and provider assignment of EHR Incentive Payments? Is there any impact of not including a provider in the Group registration if that provider no longer works with the group?

17 Group Registration (2 of 2) Can a Health Center with multiple sites have both prequalification AND using 90 day prev. year data or does the Health Center have to pick one path for all sites? If our providers work at more than one of our sites, do we have to pick the one where they work the most to register than through or do we only have to make sure they are registered one time (no duplicates)? What if two groups each list a provider? Does the provider have to choose?

18 Group Registration Resources: Quick Start Group/Clinic User Guide: PDF document Understanding Groups PDF document Contacts: California Department of Health Care Services, Office of Health Information Technology, , Medi-

19 Other Does the state/medi-cal REALLY have the money to pay us (doctors)? How long for a check to be cut if I do AIU by 12/31/11? Please explain the PA-led determination. What address do we use if the Group has an administrative address separate from the practice sites? What do we do if the NPI and Group information at the NLR does not match in the SLR and we get an error message? Does the provider assign the incentive payment at BOTH the NLR and SLR?

20 Contact Information Thank you to everyone participating in today s webinar. CalHIPSO Speranza Avram speranza@calhipso.org and Dorian Seamster, dorian@calhipso.org DHCS Raul Ramirez, raul.ramirez@dhcs.ca.gov CMS Jon Langmead, jon.langmead@cms.hhs.gov ACS Michael Marchant, Michael.Marchant@acs-inc.com CPCA Andie Patterson, apatterson@cpca.org